经阴道多普勒彩色超声联合β-hCG检测指导剖宫产后再妊娠分娩方式价值  

Value of transvaginal Doppler color ultrasound combined withβ-hCG detection for guiding delivery mode of the subseguent re-pregnant after cesarean section

作　　者：王霞 何敏 张金保 WANG Xia;HE Min;ZHANG Jinbao(The 941 Hospital of Service Support Force, Xining, Qinghai Province,81000)

机构地区：[1]联勤保障部队第941医院,西宁810000

出　　处：《中国计划生育学杂志》2022年第1期94-97,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨经阴道多普勒彩色超声联合检测血清人绒毛膜促性腺激素(β-hCG)水平对瘢痕子宫再妊娠孕妇瘢痕愈合诊断价值。方法:选取2017年1月-2019年6月本院收治的剖宫产再次妊娠晚期孕妇140例,于孕35周后择期行经阴道多普勒彩色超声和血清β-hCG水平检测,对孕妇瘢痕子宫愈合情况进行判断,并与分娩结局对照分析。结果:140例中子宫瘢痕I级117例(83.6%),β-hCG(24335.35±236.51IU/L);II级15例(10.7%),β-hCG(26456.84±313.57IU/L);Ⅲ级7例(5.0%),β-hCG(31467.67±974.51IU/L);Ⅳ级1例(0.7%),β-hCG(33451.58±1023.49IU/L),瘢痕II级、Ⅲ级、Ⅳ级孕妇血清β-hCG水平高于I级(P<0.05)。瘢痕子宫I级阴道分娩占80.3%、剖宫产占19.7%;II级阴道分娩占26.7%、剖宫产占73.3%;Ⅲ级全部剖宫产;Ⅳ级1例剖宫产。子宫瘢痕II级、Ⅲ级剖宫产率高于I级(P<0.05)。ROC曲线分析,经阴道多普勒彩色超声联合β-hCG诊断瘢痕愈合的灵敏度64.6%,特异度97.2%,AUC 0.648。结论:经阴道多普勒彩色超声联合血清β-hCG水平检测诊断瘢痕子宫再妊娠孕妇子宫瘢痕愈合有一定意义,可作为临床指导分娩方式参考。Objective:To explore the value of transvaginal Doppler color ultrasound combined with serum human chorionic gonadotropin(β-hCG)level for diagnosing uterine scar healing.Methods:140 pregnant women with scar uterus during the third trimester of pregnancy were selected from January 2017 to June 2019.After 35 gestational weeks,these women were given transvaginal Doppler color ultrasound examination and serumβ-hCG detection.The healing situation of scar uterus of these women was judged,and their delivery outcomes were compared.Results:In these 140 women,there were 117(83.57%)grade I of uterine scar and theβ-hCG level(24335.35±236.51IU/L),15(10.71%)women with grade II of uterine scar and theβ-hCG(26456.84±313.57IU/L),7(5.00%)women with gradeⅢof uterine scar and theβ-hCG level(31467.67±974.51 IU/L),and 1(0.72%)woman with gradeⅣof uterine scar and theβ-hCG level(33451.58±1023.49 IU/L).The serumβ-hCG level of the women with grade II,Ⅲ,or IV of uterine scar were significant higher than that of the women with grade I of uterine scar(P<0.05).ROC curve analysis showed that the sensitivity,the specificity,and AUC of transvaginal Doppler color ultrasound combined withβ-HCG level for diagnosing scar uterus were 64.6%,97.2%,and 0.648,respectively.The vaginal delivery of the women with grade I of scar uterus accounted for 80.3%,and their cesarean delivery accounted for 19.7%.The vaginal delivery of the women with grade II of scar uterus accounted for 26.7%,and their cesarean delivery accounted for 73.3%.The cesarean delivery of the women with gradeⅢof scar uterus accounted for 100%,and there was 1 woman with gradeⅣof scar uterus had chosen cesarean delivery.The rate of cesarean delivery of the women with grade II orⅢof scar uterus was significant higher than that of the women with grade I of scar uterus(P<0.05).Conclusion:Transvaginal Doppler color ultrasound detection and serumβ-hCG level for diagnosing uterine scar healing has good reference value,which can be as evidence for guiding delivery mode of the

关 键 词：瘢痕子宫再妊娠分娩 多普勒彩色超声 血清人绒毛膜促性腺激素 诊断瘢痕愈合价值 分娩方式 

分 类 号：R71[医药卫生—妇产科学]